Tag: statistics

Sleep Health. 2025 Oct 27:S2352-7218(25)00176-7. doi: 10.1016/j.sleh.2025.08.006. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: The goal of this study was to examine feasibility, acceptability, and preliminary efficacy of WePAP, a novel, couples-based treatment to promote positive airway pressure adherence in patients with obstructive sleep apnea and sleep quality in patients and partners.

METHODS: Patients who were recently diagnosed with obstructive sleep apnea and intended to start positive airway pressure and their partners completed pre-treatment self-report measures of study constructs and actigraphy. Couples were randomly assigned to WePAP or information control groups. Post-PAP assessments and adherence downloads were completed at 1 month and 3 months. Primary analyses evaluated feasibility, acceptability, and preliminary efficacy between the WePAP and information control groups. Secondary analyses examined between- and within-group changes in sleep, mood, and quality of life.

RESULTS: The study enrolled 37 midlife and older adults (n=74, age m=62.97; SD=9.04). WePAP couples were 100% adherent with the 3 sessions. Compared with the information control group, patients and partners in WePAP rated the intervention more favorably and were more satisfied. Positive airway pressure adherence was high in both groups and the difference was not statistically significant (PAP use ≥4h=76% in WePAP and 72% in information control at 3 months). There were significant within-group differences for sleep quality, such that patients in both groups showed significant improvements in self-reported sleep, mood, and quality of life at 3 months. Patients in both groups showed improvements in sleep-related daytime impairment; however, only partners in the WePAP group showed improvement in sleep-related daytime impairment.

CONCLUSIONS: The results demonstrate that WePAP is feasible and well-liked by patients and partners, but it did not demonstrate greater adherence or improved sleep quality in this sample of highly adherent patients. Future studies should examine longer-term outcomes and enroll patients at greater risk for nonadherence to positive airway pressure.

PMID:41152068 | DOI:10.1016/j.sleh.2025.08.006

J Orthop Sci. 2025 Oct 27:S0949-2658(25)00289-1. doi: 10.1016/j.jos.2025.10.005. Online ahead of print.

ABSTRACT

BACKGROUND: The distal femoral closing wedge osteotomy is a common method for treating the femoral deformity in knee osteoarthritis. However, due to the lack of appropriate surgical devices, there are shortcomings: difficulty of positioning hinge area, complex calculation of corrective angle, and hinge damage. This study aimed to develop a positioning device to solve the above problems.

METHODS: Computer-aided design software and three dimensional (3D) printer were used to design, modify, and print the novel device. The Sawbones experiment was used for functional verification and preliminary clinical application was conducted to evaluate the effectiveness of the device.

RESULTS: In the Sawbones experiment, with assistance of the novel device, the angle of the first positioning was more accurate than the conventional method (p < 0.05) and retained the fixed hinge width (p < 0.05). In preliminary clinical application, the average time for accurate positioning hinge was 75s and the average fluoroscopy was 2 times. Hinge fracture occurred in 1 case. The average operation time was 47 min. The hip-knee-ankle angle (HKA) improved from preoperative (171.16 ± 2.65°) to postoperative (180.55 ± 1.21°) (p < 0.01) and the mechanical lateral distal femoral angle (mLDFA) was significantly improved compared with the pre-operation (94.45 ± 1.26° vs 87.31 ± 1.10°, p < 0.01). The angle between the anatomic axis of the femur and the Blumensaat’s line (AFBL) was no statistically significant difference compared with the pre-operation (p > 0.05). After 9 months, the american knee society score (AKSS) was from preoperative (63.64 ± 4.74) to postoperative (92.82 ± 2.71) (p < 0.01) and Lysholm score was significantly improved (56.82 ± 5.38 vs 91.27 ± 2.24, p < 0.01). The pain symptoms were relieved and the visual analogue scales (VAS) was significantly reduced compared with the pre-operation (p < 0.01).

CONCLUSIONS: The positioning device had the functions of calculation-free of corrective angle and hinge retention, which was an efficient device for the distal femoral closing wedge osteotomy.

PMID:41152049 | DOI:10.1016/j.jos.2025.10.005

J Prosthet Dent. 2025 Oct 27:S0022-3913(25)00793-0. doi: 10.1016/j.prosdent.2025.10.020. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Research on the mechanical performance, particularly the fracture resistance, of recently introduced glass-composite and hybrid ceramic resin materials used with additive manufacturing (AM) and subtractive manufacturing (SM) techniques, and indicated for definitive restorations, remains limited.

PURPOSE: The purpose of this in vitro study was to evaluate and compare the fracture resistance of AM or SM crowns in different resin-based materials through fatigue cyclic loading and load-to-fracture testing.

MATERIAL AND METHODS: A standardized maxillary molar preparation was used to fabricate a zirconia master die, which was then scanned and reproduced in resin using a digital light processing (DLP) 3-dimensional (3D) printer. Two resins for AM (Pro Resins Crown X and Flexcera Smile Ultra+) and 2 resins for SM (Shofu HC and Brilliant Crios), all containing inorganic fillers (glass or ceramic), were used to fabricate identical computer-aided design (CAD) crowns (n=15). These crowns were then cemented using a standard protocol. Specimens underwent fatigue cyclic loading via 1.2 million cycles at 49 N, followed by the load-to-fracture test using a universal testing machine. Statistical analysis included 1-way ANOVA and the Tukey post hoc test (α=.05).

RESULTS: All crowns withstood cyclic loading. A statistically significant difference in fracture load was observed across different crowns manufactured by using different resin-manufacturing technology pairs (P<.001). SM-S group exhibited the lowest fracture resistance (2184 ±660.2 N), whereas the other 3 groups exceeded 2500 N, with no significant differences among them (P>.05).

CONCLUSIONS: AM crowns demonstrated fracture resistance comparable to SM crowns during and after fatigue cyclic loading and load-to-fracture tests. All crowns showed fracture resistance loads higher than previously reported clinically acceptable load values, supporting their potential for clinical use.

PMID:41152036 | DOI:10.1016/j.prosdent.2025.10.020

Dent Mater. 2025 Oct 27:S0109-5641(25)00793-6. doi: 10.1016/j.dental.2025.10.003. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to develop a bleaching hydrogel containing 6 %HP and Biosilicate®(BioS) doped with manganese oxide (MnO_BioS), irradiated with violet LED-light.

METHODS: MnO was incorporated into BioS via the oxide fusion route, and BioS/MnO_BioS (0 % and 10 %wt) were combined with 6 %HP. Particles and gel’s characterization (n = 5), bioactivity assay (FTIR), photocatalytic evaluation (MB/ppm), HP decomposition rate (%), and pH evaluation were performed. Enamel/dentin blocks (n = 10) were treated: 35 %HP (positive control), 6 %HP gels BioS/MnO_BioS (0 % and 10 % wt), irradiated or not with LED. Bleaching was performed in three 30-min sessions at 7-day intervals. Specimens were evaluated for color change (ΔE₀₀), whiteness index (ΔWI_D), surface hardness recovery (%SHR), carbonate and phosphate (CO₃²⁻/PO₄³ ⁻) ratio in enamel before (T₀) and after treatments (T₁), and surface morphology at T₁. Data were analyzed by two-way ANOVA with Tukey’s post-hoc (α = 0.05).

RESULTS: 6 %HP_MnO_BioS_LED increased gel photocatalysis, HP decomposition, and pH when compared to 6 %HP and 35 %HP (p < 0.05). 6 %HP_MnO_BioS_LED showed statistically similar results to 35 %HP in ΔE₀₀, ΔWI_D, Δa, Δb, and ΔL (p < 0.05). The 35 %HP and 35 %HP_LED showed the lowest %SHR, followed by the 6 %HP and 6 %HP_LED BioS and MnO_BioS-containing groups showed higher carbonate/phosphate ratios compared to the other groups (p < 0.05).

CONCLUSIONS: The groups containing MnO_BioS and BioS, regardless of LED-light irradiation, exhibited higher %SHR and carbonate/phosphate ratio compared to 35 %HP and 35 %HP_LED. Additionally, 6 %HP_MnO_BioS_LED increased gel pH, photocatalysis, HP decomposition and exhibited bleaching efficacy similar to 35%HP.

SIGNIFICANCE: This approach provides a safer alternative to 35 %HP gels, achieving superior bleaching outcomes with six times lower concentration of HP, while enhancing enamel calcium and phosphate levels and preserving mineral integrity.

PMID:41152034 | DOI:10.1016/j.dental.2025.10.003

Chemphyschem. 2025 Oct 28:e202500524. doi: 10.1002/cphc.202500524. Online ahead of print.

ABSTRACT

Using scanning tunneling microscopy, Cu and Co tetraphenyl monobenzo porphyrins are used as probe molecules to better understand the T-type interactions within well-ordered islands of Cu and Co tetraphenyl trans-dibenzo porphyrins on Cu(111). The islands are made up of molecular rows, held together by T-type interactions between isoindole and phenyl rings of adjacent molecules. The monobenzo molecules are found to be depleted within the bulk of the molecular rows and enriched at the edges terminating the rows. By counting over 50 000 molecules and using equilibrium considerations, the T-type interaction energies within the trans-dibenzo islands are estimated and the derived values are compared to values previously calculated with density functional theory, which find very good agreement for Cu-TPtdBP but less satisfying agreement for Co-TPtdBP.

PMID:41152015 | DOI:10.1002/cphc.202500524

Eur J Endocrinol. 2025 Oct 28:lvaf214. doi: 10.1093/ejendo/lvaf214. Online ahead of print.

ABSTRACT

OBJECTIVE: Lipodystrophy syndromes comprise a group of rare diseases characterized by loss of adipose tissue without nutritional or catabolic causes. As the rarity of these conditions necessitates collaboration, the European Consortium of Lipodystrophies (ECLip) established an international, longitudinal registry for patients with all forms of lipodystrophy (excluding HIV-associated cases).

METHODS: From December 2017 to November 2023, 19 centres from 13 countries recruited 631 patients into the ECLip registry. Cross-sectional data were analysed using descriptive statistics.

RESULTS: Prospective data was available for 467 patients (82.7%, female; 86.5% adults; median age 44.0 years). Familial partial lipodystrophy (FPLD) was the most common subtype (57.4%), especially FPLD2 (37.9%). However, in men congenital generalized lipodystrophy was nearly as common as FPLD (33.3% vs. 35.8%). Symptoms at onset varied by subtype, with loss of adipose tissue being the most frequent. More than 70% of the patients suffered from metabolic complications, particularly dyslipidaemia (59.0%) and diabetes (48.4%) but prevalence and severity varied between subtypes (prevalence of diabetes for example 76.9% in patients with acquired partial lipodystrophy vs 8.7% in acquired localized lipodystrophy). Metreleptin, the only disease-specific treatment, was used by 11.6% of all patients. 34 deaths were documented, primarily due to cardiovascular events and cancer. Patients with generalized forms of lipodystrophy died earlier compared to patients with partial forms (median age at death 27.0 vs. 72.0 years).

CONCLUSION: This study describes the largest cohort of patients with lipodystrophy reported to date. The dataset offers a comprehensive view of the epidemiology, clinical presentation, and associated comorbidities of lipodystrophy.

PMID:41152002 | DOI:10.1093/ejendo/lvaf214

Orthop Surg. 2025 Oct 28. doi: 10.1111/os.70194. Online ahead of print.

ABSTRACT

OBJECTIVE: Intraoperative femoral condylar avulsion fractures during total knee arthroplasty (TKA) are rare but potentially lead to joint instability and poor outcomes if not properly managed. However, the necessity of using condylar-constrained prostheses in these cases remains controversial. This retrospective study examines the incidence, management approaches, and radiological outcomes of these fractures.

METHODS: A total of 47 patients (11 males, 36 females; mean age 67.1 ± 7.0 years) with femoral condylar avulsion fractures were identified from 4290 TKAs performed between January 2008 and December 2022, matched with nonfracture patients at a 1:1 ratio by age, gender, and BMI. Intraoperative fractures were treated using cancellous bone screws or nonabsorbable sutures based on the size of the fracture fragment, without the insertion of condylar constrained prostheses. All patients underwent outpatient follow-up, with data collected on preoperative diagnosis, body mass index (BMI), knee range of motion (ROM), and type of prosthesis used. Key radiological indicators assessed included proximal tibia varus angle (PTVA), distal femoral valgus angle (DFVA), joint line congruence angle (JLCA), hip-knee-ankle angle (HKA), and preoperative subluxation status.

RESULTS: The incidence of femoral condylar avulsion fracture in primary TKA was found to be 1.1%. Over a follow-up period of 1.5-3 years, no instability was noted in any patients. Significant differences were observed between fracture and nonfracture groups in PTVA (82.02 ± 3.39 vs. 85.32 ± 1.87, p = 0.01), DFVA (85.53 ± 2.73 vs. 87.51 ± 5.29, p = 0.02), and HKA (8.81 ± 3.30 vs. 6.53 ± 2.21, p = 0.01). However, the Knee Society Score (KSS) at last follow-up showed no statistical difference (p = 0.05).

CONCLUSION: Femoral condylar avulsion fractures during primary TKA may be linked to joint deformities. Fixation methods using cancellous bone screws or nonabsorbable sutures, combined with a hinged knee brace, resulted in favorable clinical and radiological outcomes, with no need for prosthesis modification.

PMID:41152001 | DOI:10.1111/os.70194

JMIR Pediatr Parent. 2025 Oct 28;8:e75669. doi: 10.2196/75669.

ABSTRACT

BACKGROUND: Excessive infant crying affects approximately 20% of families and can lead to parental distress, anxiety, and strained relationships. Despite its prevalence, many parents report feeling misunderstood and unsupported during these challenging periods.

OBJECTIVE: This study aimed to gain in-depth insight into mothers’ perceptions of being understood and supported in the context of excessive infant crying, focusing on three key stakeholder groups: partners, the personal network, and health care professionals. Based on these results, the study sought to develop a maternal support framework regarding excessive crying that could guide future research and practice, as well as support strategies.

METHODS: Using a qualitative approach supplemented by quantitative measures, through an online survey, three open-ended questions were included on how mothers would like to be understood and supported by the three stakeholder groups (ideal situation) and six 6-point Likert scales on mothers’ current perceived understanding and support regarding the three stakeholder groups (current situation). Descriptive statistics were used to examine current levels of understanding and support, and an inductive thematic analysis was applied to identify the ideal key support elements.

RESULTS: Data were collected from 432 mothers (n=238, 55.1% Dutch; n=194, 44.9% Flemish; mean age 33 years, range 21-45 years). Regarding the current situation, mothers rated health care professionals lowest in perceived understanding and support, with 50.6% (n=219) feeling little or no understanding and 47.1% (n=203) reporting little or no support. Similar patterns were found in the personal network (n=184, 42.6%, and n=164, 38%, respectively). Partners were perceived as most supportive, with only 17.6% (n=76) of mothers reporting little or no understanding and 21.8% (n=94) reporting little or no support. Based on the thematic analysis of the qualitative data, the ideal situation was framed in the newly developed maternal support framework. This framework identifies 25 distinct support forms, of which 12 (48%) are common support forms (partner, personal network, health care professionals, eg, listen actively), 6 (24%) are related to partners (eg, be physically present), 6 (24%) concern the support of health care professionals (eg, refer appropriately), and 1 (4%) is specific to the personal network (cope with the crying).

CONCLUSIONS: This study underscores the need for holistic, family-centered approaches to supporting families with excessively crying infants. The proposed maternal support framework offers a foundation for developing tailored interventions that reflect the diverse roles of partners, personal networks, and health care professionals in maternal well-being.

PMID:41151046 | DOI:10.2196/75669

J Med Internet Res. 2025 Oct 28;27:e76177. doi: 10.2196/76177.

ABSTRACT

BACKGROUND: Telehealth is a potential tool to alleviate geographic clinician shortages, but there are limited data regarding current telehealth use for common cardiology conditions, including atrial fibrillation (AF).

OBJECTIVE: We aimed to evaluate variation in telehealth use in primary care and cardiology clinics for patients with incident AF in the Veterans Health Administration.

METHODS: We included patients diagnosed with AF in the outpatient setting between January 2022 and September 2023. We assessed the association between any video visit and any telehealth use (including phone) for primary care or cardiology visits within 90 days of an AF diagnosis, adjusting for selected patient- and facility-level characteristics using Bayesian logistic regression with facility-level random intercepts. We evaluated facility variation in video visit and telehealth use with the median odds ratio (MOR).

RESULTS: Our cohort included 36,929 patients with 80,596 visits across 125 facilities. Of the 63,835 primary care visits, 2088 (3.27%) were delivered via video and 13,403 (21%) via telehealth; of the 16,761 cardiology visits, 323 (1.93%) were delivered via video and 3288 (19.62%) via telehealth. On average, the mean age of the patients was 73.6 (SD 10.9) years; 2.91% (1075/36,929) were female; 77.71% (28,698/36,929) were White. In adjusted analyses, older age was associated with lower use of video visits for both primary and cardiology care and lower use of any telehealth for cardiology care (eg, adjusted odds ratio [AOR] 0.61, 95% credible interval [CrI] 0.42-0.85 for the use of video cardiology care for patients aged above 77 years). Living more than 65 km from the care site was associated with increased use of both video and any telehealth for primary and cardiology care (eg, AOR 1.91, 95% CrI 1.21-3.00 for video cardiology care); however, living in a rural location was associated with lower odds of using video or any telehealth for primary care (video: AOR 0.73, 95% CrI 0.64-0.84; telehealth: AOR 0.89, 95% CrI 0.83-0.96). There was marked variability across facilities in the use of video care (range 0%-17.4% of visits for cardiology care; 0%-12.5% for primary care) and telehealth (range 0%-82.6% for cardiology care; 3.8%-61.6% for primary care). The facility-level adjusted MOR for video care use was 1.97 (95% CrI 1.77-2.24) for primary care and 4.95 (95% CrI 3.39-7.98) for cardiology care. Similarly, the adjusted MOR for any telehealth use was 1.79 for primary care (95% CrI 1.65-1.96) and 2.61 for cardiology care (95% CrI 2.25-3.13).

CONCLUSIONS: Following an incident AF diagnosis, telehealth may increase access to primary and cardiology care for veterans living at a distance, but its use remains lower for older patients and those in rural areas. There was substantial variation in telehealth use across facilities, which was not explained by differences in patient and facility characteristics. Standardizing telehealth use across Veterans Health Administration facilities may improve access to AF care.

PMID:41151044 | DOI:10.2196/76177

J Orthop Trauma. 2025 Oct 28. doi: 10.1097/BOT.0000000000003112. Online ahead of print.

ABSTRACT

OBJECTIVE: To characterize functional recovery related to Patient-Reported Outcomes Measurement Information System (PROMIS) scores following surgical fixation of tibial plateau fractures. It was hypothesized that improvement may be seen in PROMIS scores up to the two-year timepoint.

METHODS: Design: Retrospective cohort study.

SETTING: Single Level I Trauma Center (2022-2024).

PATIENT SELECTION CRITERIA: Adults who sustained a tibial plateau fracture (AO/OTA 41) treated operatively and completed PROMIS surveys were included.

OUTCOME MEASURES AND COMPARISONS: PROMIS-physical function (PF), pain interference (PI), depression, anxiety, global physical health (GPH), and global mental health (GMH). Scores for each domain were compared across timepoints ranging from 2 weeks to 24 months postoperatively.

RESULTS: 270 patients met inclusion criteria (mean age 49.1 years [range: 18-88 years], 57.0% male). PROMIS-PF improved from 28.1 at 2 weeks to 40.6 at 1 year (+12.5, p < 0.001) and remained significantly above the two-week postoperative baseline at 2 years (39.7, +11.6, p < 0.001), though no additional change was observed between 1 and 2 years (p = 0.996). PROMIS-PI decreased from 66.1 at baseline to 58.3 at 1 year (-7.9, p < 0.001) and 60.8 at 2 years (-5.3, p = 0.004), with no significant difference between 1 and 2 years (p = 0.767). PROMIS-GPH increased from 37.3 at baseline to 43.8 at 1 year (+6.5, p < 0.001) and remained improved at 2 years (40.8, +3.5, p = 0.044). In contrast, PROMIS-GMH declined from 46.8 at baseline to 42.6 at 2 years (-4.2, p = 0.043). PROMIS-depression (54.6) and anxiety (55.0) scores did not change significantly. Patients with consistent survey participation through 6 months demonstrated significantly lower PROMIS-PF scores at 2 weeks (24.1 vs 28.1, p < 0.001) but significantly higher scores at 6 weeks (34.9 vs 28.6, p < 0.001), 3 months (36.2 vs 31.2, p < 0.001), and 6 months (40.0 vs 36.6, p < 0.001) compared with those with intermittent participation.

CONCLUSION: In patients with operatively treated tibial plateau fractures, patient-reported physical function, pain interference, and global physical health demonstrated statistically and clinically significant improvements over time, most pronounced within the first postoperative year.

LEVEL OF EVIDENCE: III.

PMID:41151038 | DOI:10.1097/BOT.0000000000003112